DR. GRACE A MONTENEGRO M.D.
NPI 1497948087
Colon & Rectal Surgery in Saint Louis, MO

Q: What is Grace Montenegro's NPI number?

The NPI number for Grace Montenegro is 1497948087. It was assigned to this individual provider in the NPPES registry on August 27, 2007.

Q: What is Grace Montenegro's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Q: When was this NPI record last updated?

The NPPES record for Grace Montenegro was last updated on February 17, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 27, 2007PECOS EnrolledAccepts Medicare Assignment

81.57/100

CMS Quality Rating

1008 S SPRING AVE, SAINT LOUIS, MO 63110(314) 977-3530(314) 977-1630 Get Directions Write a Review

NPPES record last updated: February 17, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Grace A Montenegro M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GRACE A MONTENEGRO M.D. (NPI 1497948087) is an individual colon & rectal surgery provider in Saint Louis, Missouri, licensed in Missouri (2013017017) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS, is affiliated with Ssm St Clare Health Center, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1497948087

Entity TypeIndividualFemale

Primary Taxonomy208C00000X

Provider Legal NameDR. GRACE A MONTENEGROCredential: M.D.

Location Address1008 S SPRING AVESaint Louis, MO 63110-2520

Mailing Address1008 S Spring AveSaint Louis, MO 63110-2520 · (314) 977-3530

Phone(314) 977-3530

Fax(314) 977-1630

Sole ProprietorYes

Medical School CMSOtherGraduated 2003

Enumeration DateAugust 27, 2007

Last NPPES UpdateFebruary 17, 2021

NPPES CertifiedFebruary 17, 2021

✔ NPI 1497948087 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208C00000X

License✔ Licensed in MO · 2013017017

Definition

A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.

1008 S SPRING AVE, Saint Louis, MO 63110

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Grace A Montenegro M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810202041

PECOS Enrollment IDI20150818004590

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

31 services11 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

21 services19 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

18 services16 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

18 services11 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

16 services16 patients

Diagnostic exam of anus using an endoscope 46600

This procedure involves using a thin, flexible instrument called an endoscope to examine the anal area. It helps detect any abnormal conditions or issues. It's a safe, routine exam performed by a healthcare professional.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ssm St Clare Health Center

Acute Care Hospitals · Fenton, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260081

Location1015 BowlesFenton, MO 63026 · Jefferson County

Emergency services Birthing friendly

Ssm Health St Mary's Hospital - St Louis

Acute Care Hospitals · Richmond Heights, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260091

Location6420 Clayton RdRichmond Heights, MO 63117 · St. Louis County

Emergency services Birthing friendly

Ssm Health Saint Louis University Hospital

Acute Care Hospitals · Saint Louis, MO

1/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number260105

Location3635 Vista AveSaint Louis, MO 63110 · St. Louis City County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63110 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.32 typical visit price

range $55.65 – $169.38

Typical copayment $21.58 (range $13.91 – $42.34)

Most-billed visit code 99203

Established Patient

$69.50 typical visit price

range $17.76 – $137.92

Typical copayment $17.37 (range $4.44 – $34.48)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.57/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

76.09

Promoting Interoperability

100

Improvement Activities

Cost

54.28

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy skin barrier, powder, per oz A4371

DME-Orthotic Devices · category DF010N

3 suppliers15 claims23 services$2.96 avg. paid by Medicare

Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each A4407

DME-Orthotic Devices · category DF010N

3 suppliers23 claims460 services$8.09 avg. paid by Medicare

Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each A4419

DME-Orthotic Devices · category DF010N

2 suppliers22 claims1,320 services$1.67 avg. paid by Medicare

Adhesive remover, wipes, any type, each A4456

DME-Medical/Surgical Supplies · category DA000N

4 suppliers16 claims735 services$0.21 avg. paid by Medicare

Skin barrier, wipes or swabs, each A5120

DME-Orthotic Devices · category DF010N

3 suppliers16 claims630 services$0.21 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IMAGINE ACADEMY OF ESM

Local Education Agency (LEA)